Name: Nuguit Norelyn P.

Chapter 10.

Loss is a normal and essential part of human life, allowing individuals to change, develop, and fulfill
their potential. It can be planned, expected, or sudden, and can be beneficial or devastating depending on the
situation. Grief is the emotional response to loss, involving both content and process. It is a challenging and
difficult process, often causing anticipation of future loss. Mourning is the outward expression of grief, involving
rituals like wakes, shiva, religious ceremonies, and funeral arrangements. Anticipatory grieving involves
grappling with the possibility of loss or death.Abraham Maslow's hierarchy of human needs provides a
framework for understanding loss. It starts with physiologic needs like food, followed by safety, security, and
belonging. Self-esteem needs lead to confidence and self-actualization, and when these are not met, a person
experiences loss.Nurses must understand clients' experiences of various health and illness losses to support
their emotional and physical pain during grief, ensuring they can effectively communicate and alleviate the
client's discomfort.Grief is influenced by deeply embedded personal values and belief systems, which are
central to spirituality and the spiritual response to loss. Grieving individuals may experience comfort, challenge,
or tragedy, leading to deep spiritual suffering due to abandonment, hope, or loss.

Grief can manifest in various behavioral responses, such as automatic functioning, emotional outcry,
irritability, hostility, seeking out shared activities, and avoiding valuables. These responses indicate a lack of
understanding of the loss, a desire for reconnection, and fluctuating emotions and perceptions of hope.

►Grief refers to the subjective emotions and affect that are normal responses to the experience of loss.
►Grieving is the process by which a person experiences grief.
►Types of losses can be identified as unfulfilled or unmet human needs. Maslow’s hierarchy of human needs
is a useful model to understand loss as it relates to unfulfilled human needs.
►Grief work is one of life’s most difficult challenges. The challenge of integrating a loss requires all that the
person can give of mind, body, and spirit.
►Because the nurse constantly interacts with clients at various points on the health–illness continuum, he or
she must understand loss and the process of grieving.
►The process of grieving has been described by many theorists including Kübler-Ross, Bowlby, Engel, and
Horowitz.
►Dimensions of human response include cognitive, emotional, spiritual, behavioral, and physiologic. People
may be experiencing more than one phase of the grieving process at a time.
►Culturally bound reactions to loss are often lost in the acculturation to dominant societal norms. Both
universal and culture-specific rituals
►Situations considered risk factors for complicated grief in those already vulnerable include death of a spouse
or child, a sudden unexpected death, and murder.
►During assessment, the nurse observes and listens for cues in what the person thinks and feels and how he
or she behaves, and then uses these relevant data to guide the client in the grieving process.
►Crisis theory can be used to help the nurse working with a grieving client. Adequate perception, adequate
support, and adequate coping are critical factors.
►Effective communication skills are the key to successful assessment and interventions.
►Interventions focused on the perception of loss include exploring the meaning of the loss and allowing
adaptive denial, which is the process of gradually adjusting to the reality of a loss.
►Being there to help the client while assisting him or her in seeking other sources of support is an essential
intervention.
►Encouraging the client to care for him or herself promotes adequate coping.
►To earn the client’s trust, the nurse must examine his or her own attitudes about loss and periodically take a
self-awareness inventory.
Chapter 11
Anger is a strong emotional response to perceived or real provocation, often resulting from frustration,
hurt, or fear. When handled appropriately, anger can resolve conflicts, solve problems, and energize the body,
but when suppressed, it can cause physical or emotional problems.Hostility, also known as verbal aggression,
is an emotion expressed through abuse, lack of cooperation, rule violation, or threatening behavior. It can lead
to physical aggression, which can cause harm or force compliance. Some psychiatric disorders clients display
hostile or aggressive behavior, challenging staff members.Anger, often perceived as a negative emotion, can
be a healthy reaction in unfair situations, allowing for problem-solving or conflict resolution when expressed
assertively. Anger is often seen as a negative emotion, but it can be a healthy reaction in unfair situations. It
can help in problem-solving or conflict resolution. It's essential to recognize, express, and manage anger
positively for good health. Negative reactions include physical problems like migraine headaches and
emotional issues like depression and low self-esteem. Anger suppression is common among women, who are
socialized to maintain relationships and avoid negative emotions. This suppression often results from unjust
treatment or disrespect, often from close friends. It is crucial for women to recognize the importance of anger
awareness and expression.

►Anger, expressed appropriately, can be a positive force that helps a person solve problems and make
decisions.
►Hostility, also called verbal aggression, is behavior meant to intimidate or cause emotional harm to another
and can lead to physical aggression.
►Physical aggression is behavior meant to harm, punish, or force into compliance another person.
►Most clients with psychiatric disorders are not aggressive. Clients with schizophrenia, bipolar disorder,
dementia, head injury, antisocial or borderline personality disorders, or conduct disorder, and those intoxicated
with alcohol or other drugs, may be aggressive. Rarely, clients may be diagnosed with IED.

►Treatment of aggressive clients often involves treating the comorbid psychiatric disorder with mood
stabilizers or antipsychotic medications.
►Assessment and effective intervention with angry or hostile clients can often prevent aggressive episodes.
►Aggressive behavior is less common and less intense on units with strong psychiatric leadership, clear staff
roles, and planned and adequate events such as staff–client interaction, group interaction, and activities.
►The nurse must be familiar with the signs, symptoms, and behaviors associated with the triggering,
escalation, crisis, recovery, and postcrisis phases of the aggression cycle.
►In the triggering phase, nursing interventions include speaking calmly and nonthreateningly, conveying
empathy, listening, offering PRN medication, and suggesting retreat to a quiet area.
►In the escalation phase, interventions include using a directive approach; taking control of the situation;
using a calm, firm voice for giving directions; directing the client to take a time-out in a quiet place; offering
PRN medication; and making a “show of force.”
►In the crisis phase, experienced, trained staff can use the techniques of seclusion or restraint to deal quickly
with the client’s aggression.
►During the recovery phase, interventions include helping clients relax, assisting them to regain self-control,
and discussing the aggressive event rationally.
►In the postcrisis phase, the client is reintegrated into the milieu.
►Important self-awareness issues include examining how one handles angry feelings and deals with one’s
own reactions to angry clients.
REFLECTION:

Grief and loss are universal sensations that affect all aspects of human life. They are intense
feelings that result from the breakdown of intimate ties with people, places, or even portions of
oneself. Reflecting on grief and loss illustrates the intricacies of human emotions as well as the
human spirit's resiliency.Grief is a natural emotion to loss. It encompasses a wide spectrum of
feelings, from deep sadness and despair to rage, uncertainty, and even numbness. It is not a linear
procedure, but rather a very personal and unique adventure that takes place over time. Grief can be
triggered by a variety of losses, such as the death of a loved one, the breakdown of a relationship, the
loss of a career, or even the loss of one's health or identity.
One of the most significant characteristics of mourning is its potential to make us question our
perception of ourselves and the world around us. It causes us to face our own mortality and the
transience of existence. In the midst of grief, we may ask existential questions about the meaning and
purpose of our lives, as well as the nature of love, loss, and resilience.
Finally, reflecting on grief and loss reminds us of the value of life and the need of cherishing
every moment with those we care about. It teaches us to accept the full range of human emotions
and to cherish the memories of people we have lost. And through the mourning process, we can find
healing, resilience, and even moments of joy in the middle of the suffering. Grief may permanently
alter us, but it also has the ability to inspire us to live more fully, love more deeply, and appreciate the
beauty and fragility of life.
REFLECTION:
Anger, hostility, and violence are complex, linked emotions that can have serious
consequences for both individuals and society as a whole. Reflecting on these emotions entails
investigating their causes, expressions, and potential repercussions, as well as developing
techniques for regulating and transforming them constructively.
At its core, anger is a natural and universal human emotion. It can arise in response to
perceived threats, injustices, or frustrations, and serves as a signal that something is amiss in our
internal or external environment. However, when anger is not acknowledged or effectively managed,
it can escalate into hostility and aggression.
Hostility refers to a persistent state of antagonism, cynicism, or resentment towards others. It
often stems from unresolved anger or underlying feelings of insecurity, fear, or powerlessness.
Hostile individuals may exhibit negative attitudes, behaviors, and interactions that erode relationships
and foster a toxic social environment.
Aggression, on the other hand, involves the intentional use of force, harm, or intimidation to
assert dominance, control, or retaliation. It can manifest in various forms, including verbal, physical,
or relational aggression, and can have devastating consequences for both victims and perpetrators.
Finally, focusing about anger, animosity, and aggressiveness encourages us to develop compassion,
forgiveness, and resilience in ourselves and others. It calls us to tackle the underlying causes of
these emotions and work toward a more just, egalitarian, and compassionate world in which anger is
recognized, disagreements are handled peacefully, and relationships are maintained with care and
empathy.